Is there something that can be done for frequent outbreaks of shingles (herpes Zoster)? I have severe RA and am taking Enbrel, methotrexate and folic acid.

I have severe RA. I take Enbrel, methotrexate, and folic acid for my condition. I also have had recurring shingles since I was 5 years old. I am now 46. I had a sudden onset of RA when I was 42. Since I have been on methotrexate, I have had frequent outbreaks of shingles. In the last six months I have had 23 outbreaks. My doctor said there is nothing we can do about it. Is there something I can do?

Answer: If, indeed, you are having recurrent episodes of shingles (Herpes Zoster) rather than Herpes simplex, you can consider using an oral anti-viral agent regularly to prevent the flares. Your immunosuppression with Enbrel and methotrexate is the culprit in these recurrences but you may not want to stop those medications if they are working well. I would recommend seeing an infectious disease specialist.